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Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist

2005; Elsevier BV; Volume: 96; Issue: 1 Linguagem: Inglês

10.1093/bja/aei274

1471-6771

Markus Zimmermann, Thilo Bein, A Philipp, Karl Peter Ittner, Maik Foltan, J. Drescher, Frank Weber, F. Schmid,

Neonatal Respiratory Health Research

BackgroundTo describe the use of pumpless extracorporeal interventional lung assist (iLA) for transportation of patients with severe life-threatening acute lung failure from tertiary hospitals to a specialized centre.MethodsRetrospective analysis in eight patients with severe lung failure requiring interhospital transport, in whom implementation of an iLA system at a tertiary hospital for air/ground transportation was performed.ResultsAfter implementation of iLA, a rapid increase in CO2-elimination (PaCO2 before iLA: 8.92±2.9 kPa, immediately after implementation: 5.06±0.93 kPa, 24 h after implementation: 4.53±1.20 kPa [mean±SD], P<0.05) was observed and a significant improvement in oxygenation (Pao2 before iLA: 6.66±2.26 kPa, immediately after implementation: 10.39±3.33 kPa, 24 h after implementation: 10.25±5.46 kPa, P<0.05) was noted. During transport, no severe complications occurred. Four patients died during further treatment due to multiple trauma or multiple organ failure.ConclusionsDue to ease of handling, high effectiveness and relatively low costs, iLA seems to be a useful system for treatment and transportation of patients with severe acute lung injury or ARDS suffering from life-threatening hypoxia and/or hypercapnia. To describe the use of pumpless extracorporeal interventional lung assist (iLA) for transportation of patients with severe life-threatening acute lung failure from tertiary hospitals to a specialized centre. Retrospective analysis in eight patients with severe lung failure requiring interhospital transport, in whom implementation of an iLA system at a tertiary hospital for air/ground transportation was performed. After implementation of iLA, a rapid increase in CO2-elimination (PaCO2 before iLA: 8.92±2.9 kPa, immediately after implementation: 5.06±0.93 kPa, 24 h after implementation: 4.53±1.20 kPa [mean±SD], P<0.05) was observed and a significant improvement in oxygenation (Pao2 before iLA: 6.66±2.26 kPa, immediately after implementation: 10.39±3.33 kPa, 24 h after implementation: 10.25±5.46 kPa, P<0.05) was noted. During transport, no severe complications occurred. Four patients died during further treatment due to multiple trauma or multiple organ failure. Due to ease of handling, high effectiveness and relatively low costs, iLA seems to be a useful system for treatment and transportation of patients with severe acute lung injury or ARDS suffering from life-threatening hypoxia and/or hypercapnia.